Imaging mass spectrometry assists in the classification of diagnostically challenging atypical Spitzoid neoplasms

• Type of Material: Article
• Authors: Rossitza Lazova, Yale University; Erin H. Seeley, Protea Biosciences, Inc.; Heinz Kutzner, Dermatopathologie Friedreichshafen; Richard A. Scolyer, Melanoma Institute Australia; Glynis Scott, University of Rochester; Lorenzo Cerroni, Medical University of Graz; Isabella Fried, Medical University of Graz; Milena E. Kozovska, Rabkin Dermatopathology Laboratory; Arlene S. Rosenberg, Case Western Reserve University; Victor G. Prieto, MD Anderson Cancer Center; Bahig Shehata, Emory University; Megan Durham, Emory University; Gina Henry, Emory University; Jose L. Rodriguez-Peralto, Universidad Complutense de Madrid; Erica Riveiro-Falkenbach, University of Sydney; Jochen T. Schaefer, Tufts University; Richard Danialan, Tufts Medical Center; Sylvie Fraitag, Hôpital Necker-Enfants Malades; Sonja Vollenweider-Roten, Viollier Morges SA Lausanne; Alireza Sepehr, DermDX New England; Martin Sangueza, Hospital Obrero Nro 1; Nouf Hijazi, University of British Columbia; Yamile Corredoira, University of Chile; Rachel Kowal, University of Rochester; Olga M. Harris, Universidade Federal do Rio de Janeiro; Francisco Bravo, Universidad Peruana Cayetano Heredia; Alan S. Boyd, Vanderbilt University; Ralitza Gueorguieva, Yale University; Richard M. Caprioli, Vanderbilt University
• Language: English
• Date: 2016-12-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 American Academy of Dermatology, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jaad.2016.07.007
• Title of Journal or Parent Work: Journal of The American Academy of Dermatology
• ISSN: 0190-9622
• Volume: 75
• Issue: 6
• Start Page: 1176
• End Page: +
• Grant/Funding Information: Funding: Supported in part by a grant: NIH/NIGMS 5P41 GM103391-05
• Keywords: TUMORS; MALIGNANT MELANOMAS; LUNG-CANCER; histopathology; EXPERT PATHOLOGISTS; MELANOCYTIC NEOPLASMS; SPECTRUM; Life Sciences & Biomedicine; DISCORDANCE; NEVI; Science & Technology; mass spectrometry; atypical Spitzoid neoplasm; imaging mass spectrometry; DIAGNOSIS; Dermatology; Spitzoid melanoma; Spitz nevus
• Research Categories: Health Sciences, General; Health Sciences, Pathology; Health Sciences, Oncology

Abstract

Background Previously, using imaging mass spectrometry (IMS), we discovered proteomic differences between Spitz nevi and Spitzoid melanomas. Objective We sought to determine whether IMS can assist in the classification of diagnostically challenging atypical Spitzoid neoplasms (ASN), to compare and correlate the IMS and histopathological diagnoses with clinical behavior. Methods We conducted a retrospective collaborative study involving centers from 11 countries and 11 US institutions analyzing 102 ASNs by IMS. Patients were divided into clinical groups 1 to 4 representing best to worst clinical behavior. The association among IMS findings, histopathological diagnoses, and clinical groups was assessed. Results There was a strong association between a diagnosis of Spitzoid melanoma by IMS and lesions categorized as clinical groups 2, 3, and 4 (recurrence of disease, metastases, or death) compared with clinical group 1 (no recurrence or metastasis beyond a sentinel node) (P  <  .0001). Older age and greater tumor thickness were strongly associated with poorer outcome (P = .01). Conclusions IMS diagnosis of ASN better predicted clinical outcome than histopathology. Diagnosis of Spitzoid melanoma by IMS was strongly associated with aggressive clinical behavior. IMS analysis using a proteomic signature may improve the diagnosis and prediction of outcome/risk stratification for patients with ASN.